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CHERNOBYL3. General Morbidity, Impairment, andDisability after the Chernobyl CatastropheAlexey V. YablokovIn all cases when comparing the territories heavily contaminated by Chernobyl’s radionuclideswith less contaminated areas that are characterized by a similar economy,demography, and environment, there is a marked increase in general morbidity in theformer. Increased numbers of sick and weak newborns were found in the heavily contaminatedterritories in Belarus, Ukraine, and European Russia.There is no threshold for ionizing radiation’simpact on health. The explosion of the fourthreactor of the Chernobyl Nuclear Power Plant(NPP) dispersed an enormous amount of radionuclides(see Chapter I for details). Even thesmallest excess of radiation over that of naturalbackground will statistically (stochastically) affectthe health of exposed individuals or theirdescendants, sooner or later. Changes in generalmorbidity were among the first stochasticeffects of the Chernobyl irradiation.In all cases when territories heavily contaminatedby Chernobyl radionuclides arecompared with less contaminated areas thatare similar in ethnography, economy, demography,and environment, there is increasedmorbidity in the more contaminated territories,increased numbers of weak newborns,and increased impairment and disability. Thedata on morbidity included in this chapterare only a few examples from many similarstudies.3.1. Belarus1. The general morbidity of children noticeablyincreased in the heavily contaminated territories.This includes deaths from commonAddress for correspondence: Alexey V. Yablokov, RussianAcademy of Sciences, Leninsky Prospect 33, Office 319, 119071Moscow, Russia. Voice: +7-495-952-80-19; fax: +7-495-952-80-19.Yablokov@ecopolicy.ruas well as rare illnesses (Nesterenko et al.,1993).2. According to data from the BelarussianMinistry of Public Health, just beforethe catastrophe (in 1985), 90% of childrenwere considered “practically healthy.” By 2000fewer than 20% were considered so, and inthe most contaminated Gomel Province, fewerthan 10% of children were well (Nesterenko,2004).3. From 1986 to 1994 the overall death ratefor newborns was 9.5%. The largest increase(up to 205%), found in the most contaminatedGomel Province (Dzykovich et al., 1996), wasdue primarily to disease among the growingnumber of premature infants.4. The number of children with impairedphysical development increased in the heavilycontaminated territories (Sharapov, 2001).5. Children from areas with contaminationlevels of 15–40 Ci/km 2 who were newbornto 4 years old at the time of the catastrophehave significantly more illnesses than thosefrom places with contamination levels of 5–15 Ci/km 2 (Kul’kova et al., 1996).6. In 1993, only 9.5% of children (0 to 4years old at the time of the catastrophe) werehealthy in areas within the Kormyansk andChechersk districts of Gomel Province, wheresoil Cs-137 levels were higher than 5 Ci/km 2 .Some 37% of the children there suffer fromchronic diseases. The annual increase in disease(per 1,000, for 16 classes of illnesses) in the42